Congress returns from a one-week recess, with most focus on advancing reconciliation 2.0. Before leaving for recess, House Republicans passed the reconciliation 2.0 budget resolution, and the Senate this week will begin committee-level work to advance the bill. The reconciliation 2.0 budget resolution is narrowly focused on funding US Customs and Border Patrol and US Immigration and Customs Enforcement. The resolution only includes instructions for the Senate Judiciary Committee and Homeland Security and Governmental Affairs Committee. That means provisions for the final package must fall under those committees’ jurisdictions, and must also derive savings or costs solely from their jurisdictions. Those limitations mean that it would be virtually impossible to include healthcare in reconciliation 2.0. The two Senate committees with reconciliation instructions each released text for their portion of the package last week, and they aim to begin markups next week. A Senate floor vote could be held as early as next week.
Because of the limitations on 2.0, discussion of healthcare in reconciliation has largely focused on a potential future reconciliation 3.0 package, which Republicans have described in a number of ways so far. They have talked about focusing 3.0 on improving affordability; on fighting waste, fraud, and abuse; and on increasing military spending. The 3.0 push is mostly coming from House Republicans, including House Budget Committee Chair Arrington (R-TX). So far they are largely discussing reconciliation 3.0 as a way to secure votes for reconciliation 2.0, but they are floating healthcare provisions for the potential package, including policies cracking down on fraud in healthcare and social services programs. Stakeholders will continue to watch the reconciliation 3.0 conversation closely, but the opportunity for a package to come together seems narrow, given that it is already mid-May and Republican near-unanimity would be necessary to advance it.
Senate committees will be active with healthcare hearings this week, including a Senate Aging Committee hearing on the sandwich generation and a Senate Appropriations Committee hearing on the US Food and Drug Administration (FDA) budget request. FDA Commissioner Makary is scheduled to testify amid rumors that he may soon be fired. The House Energy and Commerce Health Subcommittee is expected to hold a markup of public health reauthorization bills on Wednesday. However, at the time of publication, that markup had not yet been noticed.
In the regulatory space, we continue to keep an eye out for the final 2027 Notice of Benefit and Payment Parameters (NBPP) for the marketplaces and the federal independent dispute resolution (IDR) process operations final rule. The final NBPP could be released this week, with the IDR rule likely to follow.
In this week’s Healthcare Preview, Rodney Whitlock and Debbie Curtis join Erin Fuller to unpack the discussions around reconciliation 2.0 in the Senate and the possibility of a reconciliation 3.0.
